ipkes
More than Active
- 20
- 0
- 1
Patient Assessment
- Thread starter AShaddeau
- Start date
well I can only tell you what worked for me in passing all the 7 NREMT skill stations including the trauma and med practicals last week:
1. Get the NREMT skill sheets for trauma and medical. (and CPR/AED, BVM, NRB, backboard,,, etc .)
2. Memorize the exact steps they tell you to do. Yes, Every step. Yes, in that exact order.
3. get a dog, a spouse or some couch pillows. without looking at the skill sheet, start a timer and run thru the whole skill sheet on it/him/them and talk out loud into your ipod or tape recorder."I am arriving on scene w wearing proper BSI of gloves with goggle and 2 masks , 1 a HEPA, in my pocket. i ask is the scene safe and X replies that it is. I ask how many patients , reply 1. i call ALS stating general impression repeating the dispatch info-, MVA with one eject middleage male in pool of blood motionless and prone on the median (or any of the 15 other 'category 1 ' trauma priorities on my state transport protocols.) .. obvious head trauma and possible c spine injury . alert for possible helo evac. ..I now ask EMT partner to hold manual c spine while i assess AVPU (find pt reponsive to pain only) and I assess life threats Airway- airway patent and clear no fluids, breathing rapid and shallow, carotid pulse slow weak ..distal pulse present...etc. thru the whole skill sheet.
then play back what you just recorded as all your assessments. and compare what you said to the skill sheet. you will flunk yourself 20 times before you run thru the whole skill sheet completely 'right' and in proper order. .( take a med or trauma hypo from your AAOS or Limmer book and use that as your problem.)
i found my most common mistakes were not calling ALS , not upgrading transport to rapid or helo, and forgetting to check RR, breathing , pulse and PMS both before and after all interventions. i(ncluding epi, albuterol, NG, ASA, charcoal, glucose, o2, blankets, backboards, KEDs , putting splints, sling/swathes on, putting bandages or c - collars on...)
so make your own mnemonics--mine was 'don't be snagged': BSNAAG for: Bsi /Scene safe, Als, Assist (/fire-vertical rescue electric co. etc) and Gen impression -- then move to CA-ABC-CAOT: C (hold manual C - spstabilization) -AVPU- Air Breathe Circ -C Collar put on - Als upgrade (intercept or helo?), o2 (they always need o 2 ) and T (where to transport: burn unit, neuro, decompression chamber? trauma 1, general hospital ?)
then you can DCAPTBL and PMS them thru the 90 sec rapid trauma, then backboard them while SAMPLE and OPQRST them. ask the examiner each and every question head to toe in rapid trauma:Am I seeing blood or teeth blocking airway ,skin normal color ? am i seeing normal cap reflex, lost distal pulse, raccoon eyes battle signs frothy blood , JVDs, SQt edema, rales ronchi wheezes punctured chest walls, rigid abdomens, cullen signs , non PEARRLs, CSF from ears or nose, the whole litany of every awful thing you can think of from head to toe. then finish the alphabet soups , tell examiner helo is on scene and state you'll treat the ever present distracting injury (like , splint the closed broken ankle etc.) during transport, ) stating 'i am taking vitals during transport and I am reassessing ABCs and all interventions including PMS ..every (5 or 15) minutes then state ALS or HELO is here we are loading , i am radioing in my field impression : male 30 yo /glasgow coma scale 5 head injury / o 2 intervention / neuro unit at hospital X has been alerted/ helo transport ETA __ minutes...
remember that the examiner is writing on his/her paper as you do things. s/he has to hear you do something to award the point. if you skip out of order they will have a more difficult time giving you the check off for doing that particular skill because they have to jump ahead or back on the skill sheets. memorize your chosen alphabet soups, do everything in NREMT order, make their examiner-lives simple. you have now finished the whole trauma station within the ten minutes allowed for NREMT Trauma Station skills .. and gotten 42 of 42 possible points (29 required to pass with no critical fails of forgetting an ABC or forgetting a PMS or the other long list of things...)
google NREMT skill sheets .
good luck.
1. Get the NREMT skill sheets for trauma and medical. (and CPR/AED, BVM, NRB, backboard,,, etc .)
2. Memorize the exact steps they tell you to do. Yes, Every step. Yes, in that exact order.
3. get a dog, a spouse or some couch pillows. without looking at the skill sheet, start a timer and run thru the whole skill sheet on it/him/them and talk out loud into your ipod or tape recorder."I am arriving on scene w wearing proper BSI of gloves with goggle and 2 masks , 1 a HEPA, in my pocket. i ask is the scene safe and X replies that it is. I ask how many patients , reply 1. i call ALS stating general impression repeating the dispatch info-, MVA with one eject middleage male in pool of blood motionless and prone on the median (or any of the 15 other 'category 1 ' trauma priorities on my state transport protocols.) .. obvious head trauma and possible c spine injury . alert for possible helo evac. ..I now ask EMT partner to hold manual c spine while i assess AVPU (find pt reponsive to pain only) and I assess life threats Airway- airway patent and clear no fluids, breathing rapid and shallow, carotid pulse slow weak ..distal pulse present...etc. thru the whole skill sheet.
then play back what you just recorded as all your assessments. and compare what you said to the skill sheet. you will flunk yourself 20 times before you run thru the whole skill sheet completely 'right' and in proper order. .( take a med or trauma hypo from your AAOS or Limmer book and use that as your problem.)
i found my most common mistakes were not calling ALS , not upgrading transport to rapid or helo, and forgetting to check RR, breathing , pulse and PMS both before and after all interventions. i(ncluding epi, albuterol, NG, ASA, charcoal, glucose, o2, blankets, backboards, KEDs , putting splints, sling/swathes on, putting bandages or c - collars on...)
so make your own mnemonics--mine was 'don't be snagged': BSNAAG for: Bsi /Scene safe, Als, Assist (/fire-vertical rescue electric co. etc) and Gen impression -- then move to CA-ABC-CAOT: C (hold manual C - spstabilization) -AVPU- Air Breathe Circ -C Collar put on - Als upgrade (intercept or helo?), o2 (they always need o 2 ) and T (where to transport: burn unit, neuro, decompression chamber? trauma 1, general hospital ?)
then you can DCAPTBL and PMS them thru the 90 sec rapid trauma, then backboard them while SAMPLE and OPQRST them. ask the examiner each and every question head to toe in rapid trauma:Am I seeing blood or teeth blocking airway ,skin normal color ? am i seeing normal cap reflex, lost distal pulse, raccoon eyes battle signs frothy blood , JVDs, SQt edema, rales ronchi wheezes punctured chest walls, rigid abdomens, cullen signs , non PEARRLs, CSF from ears or nose, the whole litany of every awful thing you can think of from head to toe. then finish the alphabet soups , tell examiner helo is on scene and state you'll treat the ever present distracting injury (like , splint the closed broken ankle etc.) during transport, ) stating 'i am taking vitals during transport and I am reassessing ABCs and all interventions including PMS ..every (5 or 15) minutes then state ALS or HELO is here we are loading , i am radioing in my field impression : male 30 yo /glasgow coma scale 5 head injury / o 2 intervention / neuro unit at hospital X has been alerted/ helo transport ETA __ minutes...
remember that the examiner is writing on his/her paper as you do things. s/he has to hear you do something to award the point. if you skip out of order they will have a more difficult time giving you the check off for doing that particular skill because they have to jump ahead or back on the skill sheets. memorize your chosen alphabet soups, do everything in NREMT order, make their examiner-lives simple. you have now finished the whole trauma station within the ten minutes allowed for NREMT Trauma Station skills .. and gotten 42 of 42 possible points (29 required to pass with no critical fails of forgetting an ABC or forgetting a PMS or the other long list of things...)
google NREMT skill sheets .
good luck.